Search Results (28)

Background and Objectives: Recurrent urinary tract infection (rUTI) remains common and burdensome, with growing emphasis on antibiotic stewardship and non-antibiotic prevention. We characterized what women with rUTI know, do, and receive in everyday care and identified gaps between patient understanding and guideline-concordant management. Materials and Methods: We conducted a single-center, cross-sectional survey of consecutive adult women presenting with rUTI to a urology clinic in Poland. A structured questionnaire captured demographics, knowledge, symptoms and triggers, diagnostics, treatments and prevention, and satisfaction. Responses were standardized a priori; descriptive statistics and exploratory comparisons were performed (N = 36). Results: The mean age was 53.0 years (SD: 14.8). Only 36.1% identified the correct rUTI definition, while 83.3% recognized bacteria as the common cause. The symptom profile was dominated by frequency and dysuria (each 88.9%); 27.8% reported intercourse as a precipitant, and this was more frequent among sexually active women (43.5% vs. 7.7%; p = 0.031). Over half (55.6%) perceived no seasonality. The median number of episodes in the prior year was five (IQR 4–6). Urine culture was obtained before treatment in 38.9% and after treatment in 13.9%. The overall satisfaction with care was low to moderate (13.9% were very satisfied, 61.1% were moderately satisfied, and 25.0% were dissatisfied). Prior antibiotic exposure included ciprofloxacin (55.6%), furazidin (75.0%), and fosfomycin (47.2%). The uptake of preventive options was uneven: immunoactive vaccines accounted for 19.4%, methenamine hippurate for 16.7%, pelvic floor physiotherapy for 33.3%, and vaginal estrogen for 5.6% overall (9.5% among women ≥ 50 years). Conclusions: In this clinic-referred cohort, rUTI was frequent and disruptive, factual knowledge was limited, urine culture use was inconsistent, and fluoroquinolone exposure remained common. Preventive care was misaligned with guidelines, with underuse of vaginal estrogen and variable adoption of non-antibiotic strategies. Targeted education, stewardship, and structured access to evidence-based prevention may improve outcomes. Full article

Methenamine, a urinary antiseptic with antimicrobial properties, decomposes into toxic formaldehyde under acidic conditions. Its use is prohibited in dairy cattle in Korea to prevent harmful residues in milk. This study was designed to develop and validate a sensitive and reliable LC–MS/MS method for determining methenamine in raw milk and bovine muscle in compliance with the Positive List System (PLS) regulations. Samples were extracted with acetonitrile (ACN)–methanol (MeOH) (7:3, v/v) containing ammonia water, followed by defatting with n-hexane and purification with primary secondary amine (PSA). Chromatographic separation was performed on a hydrophilic interaction liquid chromatography (HILIC) column, and quantification was conducted using matrix-matched calibration to minimize matrix effects. The method showed excellent linearity (R² > 0.999), low limits of quantification (LOQ) (0.49 μg/kg for raw milk; 0.64 μg/kg for bovine muscle), and acceptable recoveries (78.1–102.8%) with precision (CV ≤ 8.75%), meeting Codex CAC/GL 71-2009 criteria. Stability studies demonstrated that methenamine remained stable in stock solutions, working standards and processed extracts under the storage and handling conditions used. Application to incurred samples resulted in the detection of methenamine in 2 of 32 raw milk samples (0.65 and 1.14 μg/kg) but in none of the 25 bovine muscle samples, with all detected levels below the Korean PLS limit. These findings confirm that the developed method is accurate, sensitive, and applicable for routine surveillance of methenamine residues to ensure consumer safety. Full article

Background/Objectives: Granulomatous lesions of the head and neck arise from diverse infectious and non-infectious causes, with tuberculosis (TB) being a predominant etiology. This retrospective study analyzed 42 cases from the archives of university of Baghdad, College of Dentistry (1975–2025). This study aimed to characterize the clinicopathological features of these lesions and to assess the diagnostic performance of histochemical stains and real-time PCR in identifying infectious etiologies—particularly Mycobacterium tuberculosis—in formalin-fixed, paraffin-embedded (FFPE) tissue samples. Methods: Definitive diagnoses included 25 TB cases confirmed through clinical, microbiological, and therapeutic follow-up at the Baghdad Tuberculosis Institute, and 17 non-TB cases classified by predefined clinicopathological criteria supported by relevant clinical data. Zieh–Neelsen (ZN), Periodic acid–Schiff (PAS), and Grocott methenamine silver (GMS) stains were employed to identify acid-fast bacilli and fungal organisms. Statistical analysis was performed using SPSS version 26, with significance set at p ≤ 0.05. Results: The mean patient age was 36.28 years (SD = 20.6), with a female predominance (59.5%). Necrotizing granulomas were identified in 69% of cases and were strongly associated with tuberculosis, which was detected in 59.5% of specimens. ZN staining showed a sensitivity of 16.7% for tuberculosis, while PCR sensitivity was highly dependent on sample age. The detection rate was 33.3% in samples archived for less than 10 years but only 10% in older samples, resulting in an overall sensitivity of 24.0% for tuberculous cases. Langhans-type giant cells were significantly more frequent in necrotizing granulomas and strongly associated with tuberculosis infection (p = 0.001). Fungal infections, predominantly aspergillosis, were confirmed by PAS and GMS in 11.9% and 9.5% of cases, respectively, and were confined to non-necrotizing granulomas. The mandible was the most commonly affected site, and soft tissue lesions were significantly associated with necrotizing granulomas (p = 0.004). Conclusions: These findings underscore the complementary role of histopathology, histochemical stains, and molecular diagnostics in improving the evaluation and diagnosis of granulomatous inflammation in head and neck lesions. Full article

Background: There is an urgent need for novel treatment options for Neisseria gonorrhoeae. Methenamine is an interesting urinary antiseptic with a very low propensity to induce antimicrobial resistance. Methods: We assessed the MICs of methenamine-hippurate for 18 N. gonorrhoeae isolates. We then assessed the in vivo efficacy of methenamine-hippurate against N. gonorrhoeae using the Galleria mellonella infection model. Results: We found that all the gonococcal isolates had a methenamine-hippurate MIC of 300 mg/L. This MIC was not higher in isolates with higher ceftriaxone MICs. No toxicity of methenamine at the doses tested was found, and doses as low as 200 mg/kg were effective in the G. mellonella model. Conclusions: Further studies in mice and humans are required to assess if methenamine-hippurate could be used to treat gonococcal urethritis alone or in combination with other agents such as ceftriaxone. Full article

Nocardia spp. are opportunistic pathogens of humans, domestic animals, and wildlife that can cause high levels of morbidity and mortality. Here, we present a unique case of nocardial airsacculitis in a free-ranging mallard (Anas platyrhynchos) from Arizona, USA, and compare it to the hosts, geographic distribution, diagnostic methodology, and infection site of known nocardiosis cases in birds. A gross necropsy, histopathology, and bacterial culture were performed. There were no gross findings associated with the nocardiosis. Histopathology showed multiple granulomas expanding the air sac with intralesional filamentous bacteria that were Grocott’s methenamine silver-positive, Fite–Faraco and Ziehl–Neelsen acid-fast, positive with the Periodic acid–Schiff reaction, and variably Gram-positive. The organism was isolated in culture and identified as Nocardia cyriacigeorgica based on the sequencing of a 463 bp portion of the 16S rRNA gene. While reports of nocardiosis in the class Aves are rare and some are possibly misdiagnosed due to limited diagnostics, cases are reported globally, sometimes resulting in epizootics. More information is needed to understand whether immunosuppression plays a role in disease development in birds. Known to be an emerging pathogen in humans, N. cyriacigeorgica can be considered as a differential diagnosis for pulmonary and potentially cutaneous or disseminated infections in birds. Full article

An in vitro 3D model using fungus colonized Reconstructed Human Epidermis (RHE) represents an effective preclinical model to simulate the pathological conditions of onychomycosis. We evaluated the suitability of this 3D onychomycosis model and use it to assess the effects of topical products on fungus growth and nail structure. Five sets of differentiated RHE were colonized with Trichophyton rubrum and covered with bovine nails. Colonized RHE with no product application (CNA) served as the control. Four different products classified as medical devices were applied once daily on the nails: Urgo Damaged Nails (UDN), Excilor (EXlor), Poderm Purifying (PDermP), Poderm Booster (PDermB). After 5 days, T. rubrum presence was visualized by the Grott Methenamine Silver staining method and quantified as the sum signal intensity of processed acquisitions. Fungal hyphae and the nail structure were analyzed by SEM. A semi-quantitative evaluation of fungal presence showed a reduction after UDN (−34%, p < 0.001) and EXlor (−28%, p < 0.020) applications compared to CNA. No significant difference was observed after PDermP applications (−2%). The nail structure appeared preserved after UDN applications and severely damaged after EXlor and PDermP applications. These findings demonstrate significant effects of different products on fungal growth and nail structure, suggesting that this 3D model might be a valuable tool for predicting the effects of antimycotic treatment in humans. Full article

Recurrent urinary tract infection (rUTI) is a significant public health problem in women. General measures to prevent recurrence include behavioral changes and increased fluid intake, cranberry ingest, use of methenamine hippurate, antibiotic prophylaxis, D-mannose, probiotics, or vaccines. We conducted a literature review of the latest updates on preventing rUTI in December 2024. The search concluded with 27 articles that fulfilled our inclusion criteria. Our review demonstrated that behavioral changes such as correct genital hygiene, avoiding postponing micturition or defecation, urinating after sexual intercourse, and ingesting 1.5–2 L of water could prevent rUTI. The ingestion of cranberries reduces the risk of symptomatic, culture-verified urinary tract infections in women with rUTIs. Methenamine hippurate is an alternative to antibiotics to avoid rUTI. Estrogen reduces rUTI in women with hypoestrogenism. Limited evidence supports using D-mannose, probiotics, and vaccines to prevent rUTI. In conclusion, after successful treatment of the acute episode, preventative measures are needed to reduce rUTI frequency and morbidity according to each patient’s characteristics and preferences. Full article

Worldwide, urinary tract infections (UTIs) have an increased incidence, especially in women. Recurrent UTIs (rUTIs) appear in less than three months in 80% of the cases, being associated with age, sexual activity, or diabetes mellitus. Antibiotics represent the first line of treatment for rUTIs after the diagnosis based on a positive mid-stream urine (MSU) culture. Alternative therapies including low-dose antibiotic treatment, immunoprophylaxis, cranberry extracts, probiotics, D-mannose, intravesical instillations, methenamine, and estrogens may reduce the recurrence of UTIs in female patients. Multimodal therapy seems to be the future in preventing and treating rUTIs. The main aim of this narrative review is to present the actual therapeutic challenges and the most efficient prophylaxis options in women diagnosed with rUTIs. Full article

In June 2024, a 41 year-old woman presented to the infectious diseases outpatient clinic with a left inguinal mass progressing in size. The patient had previously been on vacation in Greece. When a tumor was initially suspected, the mass was surgically removed. Staining with Grocott methenamine silver and Alzian blue were inconspicuous, but histopathologic examination revealed a clear histiocytic demarcation, followed by a confirmation of the suspected diagnosis of dirofilariasis caused by Dirofilaria repens by PCR. Even though still a rare event in Austria, the number of human D. repens cases has been continuously increasing in recent years. This is partly due to the increased spread of the parasite due to climate change and globalization. Full article

Background/Objectives: The accumulation of uric acid in arteriosclerotic plaques has recently attracted attention. Because the interaction between hyperuricemia and atherosclerosis is complex, the details remain obscure. We aimed to elucidate the clinical effect of monosodium urate monohydrate (MSU) deposition on carotid plaques. Methods: This study enrolled 89 patients with carotid plaques. MSU deposits were confirmed using Gomori’s methenamine silver staining of carotid endarterectomy (CEA) specimens. To evaluate the macrophage and microvessel marker counts, we used CD68 and CD31. Plaque composition was investigated in carotid plaques with MSU deposition and inflammation. We also examined the use of dual-energy computed tomography (DECT) and compensated for pathological findings to detect MSU crystal deposition in carotid plaques. Results: Of the 89 patients who underwent CEA, 31 (34.8%) had hyperuricemia. Overall, 22 (24.7%) participants had MSU deposits and 67 (75.3%) did not. MSU deposits, CD31-positive microvessels, and CD68-positive cells were observed in shoulder lesions. The number of CD31-positive microvessels and CD68-positive cells was higher in patients with MSU deposits than in those without MSU deposits. Most plaques expressing MSU were plaques with intraplaque hemorrhage. The consistency in MSU deposit identification between histopathology and DECT was poor (kappa = 0.34). Conclusions: MSU deposition may be related to the inflammation of carotid plaques. Full article

The brown planthopper (BPH), Nilaparvata lugens (Stål, 1854), is a pest of rice plants worldwide. Cordyceps javanica is a destructive entomopathogenic fungus known to attack leafhoppers or BPHs specifically. Live adult BPH samples were inoculated with isolated C. javanica PSUC002, and their interaction was morpho-histologically examined from 0 to 120 h post-inoculation (pi). We observed that the mortality of BPH continuously increased until 120 h pi (Day 5). Tissue alterations in the host were examined after infection using morphological and histological methods, including the Grocott Methenamine Silver stain test (GMS). Filamentous fungi were first found on the external integument at 12 h pi, and fungal conidia attached to the integument at 24 h pi. However, the initial degeneration of BPHs was identified by histology at 6 h pi especially in the integument and adipose tissue. We identified the degeneration and loss of integument and adipose tissue of infected BPHs at 12 h pi, and their necrosis was completed at 96 h pi. The enzymatic index of the sampled fungi (chitinase and protease) peaked at 7 days of incubation. This study demonstrated that C. javanica PSUC002 is useful to control the BPHs as an eco-friendly practice and will possibly be applied in agriculture. Full article

The importance of decellularized extracellular matrix (dECM) as a natural biomaterial in tissue engineering and regenerative medicine is rapidly growing. The core objective of the decellularization process is to eliminate cellular components while maximizing the preservation of the ECM’s primary structure and components. Establishing a rapid, effective, and minimally destructive decellularization technique is essential for obtaining high-quality dECM to construct regenerative organs. This study focused on human umbilical cord tissue, designing different reagent combinations for decellularization protocols while maintaining a consistent processing time. The impact of these protocols on the decellularization efficiency of human umbilical cord tissue was evaluated. The results suggested that the composite decellularization strategy utilizing trypsin/EDTA + Triton X-100 + sodium deoxycholate was the optimal approach in this study for preparing decellularized human umbilical cord dECM. After 5 h of decellularization treatment, most cellular components were eliminated, confirmed through dsDNA quantitative detection, hematoxylin and eosin (HE) staining, and DAPI staining. Meanwhile, Masson staining, periodic acid-silver methenamine (PASM) staining, periodic acid-Schiff (PAS) staining, and immunofluorescent tissue section staining results revealed that the decellularized scaffold retained extracellular matrix components, including collagen and glycosaminoglycans (GAGs). Compared to native umbilical cord tissue, electron microscopy results demonstrated that the microstructure of the extracellular matrix was well preserved after decellularization. Furthermore, Fourier-transform infrared spectroscopy (FTIR) findings indicated that the decellularization process successfully retained the main functional group structures of extracellular matrix (ECM) components. The quantitative analysis of collagen, elastin, and GAG content validated the advantages of this decellularization process in preserving and purifying ECM components. Additionally, it was confirmed that this decellularized matrix exhibited no cytotoxicity in vitro. This study achieved short-term decellularization preparation for umbilical cord tissue through a combined decellularization strategy. Full article

Onchocerciasis treatment and control relies mainly on the use of ivermectin which has high activity against the microfilarial stage of Onchocerca volvulus but limited activity against the long-lived, tissue dwelling adult nematodes. As this neglected tropical disease has now been targeted for elimination, there is an urgent need for new drugs to combat these parasites, ideally with macrofilaricidal activity. In this study, we have examined the anti-Onchocerca activity of a range of existing FDA-approved drugs with a view to repurposing, which can lead to rapid and relatively inexpensive development. From the Pharmakon-1600 library, 106 drugs were selected and tested against O. gutturosa adult male parasites using a concentration of 1.25 × 10⁻⁵ M in an in vitro 5-day standard assay to assess motility and viability (using MTT/formazan colorimetry). The findings revealed that 44 drugs produced marginal/moderate activity (50–99% motility and/or MTT reductions) including cefuroxime sodium, methenamine, primaquine phosphate and rivastigmine tartrate, while 23 drugs produced good activity (100% motility reductions and significant MTT reductions), including atovaquone, isradipine, losartan, rifaximin, cefaclor and pyrantel pamoate. Although this study represents only a first step, some of the identified hits indicate there are potential anti-Onchocerca drug candidates worthy of further investigation. Full article

Hexamethylenetetramine, an aldehyde-releasing agent, is used as a preservative in various food, cosmetics, and medical treatments, such as a treatment for urinary tract infections. It has been reported to be allergenic on contact with the skin, with the additional possibility of causing toxicity once absorbed systemically. Despite its potential toxicity, there are no reports on the in vivo bioavailability of hexamethylenetetramine following oral or dermal administration. In this study, we developed a new simple and sensitive LC–MS/MS method for the determination of hexamethylenetetramine in plasma and applied this method to characterize the toxicokinetics. The developed assay had a sufficient specificity and sensitivity for toxicokinetic characterization, and its accuracy and precision were verified. Following iv injection, the plasma concentration of hexamethylenetetramine showed mono exponential decay, with an elimination half-life of about 1.3 h. Following oral administration, the T_max reached an average of 0.47 h and bioavailability was estimated as 89.93%. After percutaneous administration, it reached C_max on average at 2.9–3.6 h. Although the absorption rate was relatively slow, its average bioavailability was calculated as 77.19–78.91%. Overall, most of the orally and percutaneously administered hexamethylenetetramine was absorbed into systemic circulation. The derived results in this study are expected to be utilized as the scientific evidence for further toxicokinetic study and risk assessment. Full article

Females and males with recurrent urinary tract infections may receive prescription prophylaxis to reduce the infection frequency. Little is known about how prescription prophylaxis differs between patients meeting and exceeding the minimum threshold for recurrent urinary tract infections. The objectives of this study were to estimate the association between infection frequency and receipt of prescription prophylaxis and describe the type of prescription prophylaxis initiated. This observational study used de-identified fully-insured commercial insurance data from the Midwest from 2003–2016 to identify females and males under age 64 with recurrent urinary tract infections. The patients were categorized as having three or more urinary tract infections in twelve months or only two infections in six months. Multiple logistic regression models were used to determine the association between the infection frequency and receipt of prophylaxis. The frequency of the type of prophylaxis initiated was measured. The odds of receiving prophylaxis were greater in the females and males with three or more infections compared to the patients with only two infections. Estrogen prophylaxis was initiated at a higher rate in females aged 45–63 with two infections than the females with three or more infections. Prescription prophylaxis in females and males with recurrent urinary tract infections differs between those meeting and exceeding the minimum frequency threshold. Full article